This page has been edited 2 times. The last modification was made by - cwongmd on Dec 1, 2015 8:29 pm
CLOMID INSTRUCTIONS
These are instructions for patients with oligomenorrhea. If they have regular menses, start with the Day 1 instruction.
If they do NOT have regular menses: Take Progesterone 100 mg a day (or Provera 10 mg/day) for 10 days. Some days after progesterone is stopped, or sometimes before the 10 days are up, your patient will have a period. If your patient's period starts before the 10 pills are done, stop the Progesterone then.
Consider the first day of bleeding Day 1
Days 5-9: Take one (or 2, etc.) Clomid a day. (There is variability among GYNs for the start date, varying from Day 2-5. The basic idea is to take it for 5 days.)
If the dose is correct your patient will ovulate around days 12-14. Use an ovulation kit to confirm or order a Progesterone level for Day 21-22 . Be sure to instruct your patient to have sex one to three times in that time interval.
Around day 28-30, your patient will probably have a period. If so, resume the instructions above starting day 5 with Clomid. (It takes an average of 3 months, at the correct dose, to conceive).
If your patient does not have a period, check a pregnancy test.
If she is not pregnant and does not have a period, resume the instructions starting with progesterone again, increasing the Clomid dose during the next cycles.
Schedule a follow up appointment in 3 months. If an ovulation kit or progesterone levels indicates no ovulation, increase the dosage.
Maximum dosage of Clomid is 150mg/day. Some GYNs go up to 300 but risks of ovarian hyperstimulation with dangerous ascites, etc. go up so if they do not ovulate by 3 pills/d x 5 d, refer to GYN. Once a patient ovulates, even if they are not conceiving, stay hopeful on that dose for up to 6 months. (Consider a hysterosalpingogram if not they are not pregnant after 3 months.)
This page has been edited 2 times. The last modification was made by -